Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02156 | Date 27/11/2018 |
| Token No | SM/18-19/4288 28/11/2018 | Serial | 020 Last Visit: 11/07/2019 |
| Patient Name | Mr. RIYA YADAB | Contact No | 9836262667 |
| Address | CHATRA DOL TALA | Age | 11 YRS Male |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||